VRE Infection Control Needs Regional Strategy
Lee's research modeled actual cases of patients colonized with VRE at 29 hospitals in Orange County, CA. A 10% increase in VRE colonization prevalence in any one hospital resulted in a 2.8% average relative increase in VRE prevalence in all 28 other hospitals.
The modeling program, which Lee likens to a "Sim City" of healthcare infection transmission, found that VRE bacteria persisted in infecting patients for years later, and in some cases took more than 10 years to fully manifest.
Asked if regional government authorities, such as those that exist for emergency room coordination and paramedic response, or trauma care, or more robust state or county health department infection control powers, might help overcome the practice of competitive secrecy over such outbreaks, Lee says they probably could.
"Think of these pathogens as like invaders from space. The response we have today is like having every single state setting up its own defense system and not really talking with each other. So you really need a coordinating authority and incentives to get everyone together to say this is a common enemy, a common threat," adding that hospital teams "need to see the big picture, that this affects everyone."
If a hospital knew, for example, that an outbreak of VRE had occurred at another facility from which they are likely to receive transfers, or transfer patients to, "you can step up screening measures and contact precautions, and you may want to divert resources toward that hospital. If they can't control the outbreak, it will become a problem in other hospitals, just growing, and mushrooming for months or even years."
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